Telehealth Visits (THV)

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Dear Urology Associates of Norwalk Patient,

Please read the following notice and if you would like to request a Telehealth Visit (THV) complete the "Patient Information" section below:

The COVID-19 pandemic has created significant changes in our current health care system, both for patients and healthcare providers. The goal of our practice is to always provide the best health care to our patients, while protecting the wellbeing of our patients, staff and physicians. In order to observe government mandated social distancing rules to stop the spread of COVID-19 in our communities, we will minimize face-to-face encounters for non-urgent, non-essential visits with our patients, but still provide access to care via telehealth visits (THV). During THV, the patient and physician will be able to communicate remotely using both an audio and visual platform at a scheduled appointment time.

Our goal is to weigh the risks and benefits of a THV vs. a face-to-face visit and then determine on a case by case basis which option is best for the patient. The THV is not for use for medical emergencies. If you are having a medical emergency, go to the nearest emergency room or call ‘911’. We will continue to see patients with urgent or acute health issues (including, but not limited to certain cancer treatments or consultations, obstructing stones, and other blockages within the urinary system) in our office or in a hospital setting.

If you and your physician decide to conduct a THV, our staff will provide necessary information on how you will connect with participating physicians in real time via live streaming video and audio. The THV is not intended to completely replace a face-to-face visit with your doctor. There are certain risks and limitations to the THV. These include but are not limited to the following issues:

  1. Despite our best efforts to protect the privacy of patient information, a breach in security could occur, exposing the privacy of personal medical information
  2. Information provided by THV may be insufficient to allow for a specific diagnosis and treatment plan and you still may need a face-to-face visit after your THV.
  3. A true “physical exam” cannot be performed, which may limit the physician’s diagnostic capabilities. During the THV a recommendation may be made to the patient regarding a physical exam and when it should be performed. It is the patient’s responsibility to make and keep this follow up appointment.
  4. Bloodwork or radiographic studies (ultrasound, CT scan, MRI) may be recommended and ordered. It is the patient’s responsibility to schedule these tests and follow up with the physician by phone regarding the results thereafter.
  5. Delays in diagnosis and treatment as they relate to the above issues could adversely affect the patient’s health.

The current medical landscape is changing rapidly. Currently THV are accepted and approved by most insurance plans. Our office will bill you for the THV. In some instances, you will not be charged a copay or be subject to coinsurance payment. Every insurance plan is different, so please contact your carrier if you have specific questions about your telehealth visit (THV) or would like the details of your payment responsibility.

Sincerely,

The Physicians and Staff of Urology Associates of Norwalk, P.C.
12 Elmcrest Terrace
Norwalk, CT 06850
203-853-4200

Patient Information

By clicking on the "Submit" button below, I declare that I have read and accept the above statement and understand the goals and limitations of the THV. I agree that I am requesting a THV and will give my verbal consent to the THV once the appointment starts.

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